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General NPI Number Information
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NPI Number | 1235014754
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Entity Type | Individual
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Provider Name | DEMPSEY KEVIN GOODALE PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 500 CONGRESS ST
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City | QUINCY
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State | MA
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Zip | 02169-0908
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Country | US
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Telephone | 617-376-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 3587 WASHINGTON ST APT 3
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2669
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Country | US
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Telephone | 860-899-4051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA101936
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License Number State | MA
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